Tamerayehu Tolla, A-GNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2023010980 Issued in MO

Practice address

400 E Red Bridge Rd Ste 207
Kansas City, MO 64131-4030

Phone

(913) 681-2398

Fax

(913) 681-2416

NPI assigned

Mar 1, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS, MO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

University of Missouri, Kansas City, School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  MO

  Medicare reassignment Care Compare group NPD
• Complexcare Medical Group Midwest H PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1457144933

  MO

  Medicare reassignment NPD
• NTTR Medical LLC

  • Internal Medicine Physician
  • Lenexa, KS
  • NPI 1740641455
  Medicare reassignment NPD
• Signify Health Medical Associates of Kansas LLC

  • Multi-Specialty Clinic/Center
  • Wichita, KS
  • NPI 1780261701
  Medicare reassignment NPD
• Complexcare Medical Group Kansas H LLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1073407227

  KS

  Medicare reassignment
• Theoria Medical

  • Internal Medicine Physician
  • Brighton, MI
  • NPI 1164186946
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1154020998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E RED BRIDGE RD STE 207",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641314030",
            "telephone_number": "913-681-2398",
            "fax_number": "913-681-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E RED BRIDGE RD STE 207",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641314030",
            "telephone_number": "913-681-2398",
            "fax_number": "913-681-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLA",
        "first_name": "TAMERAYEHU",
        "credential": "A-GNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2023010980",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KS",
            "license": "53-81975-102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gladesia Lenea Tolbert, PNP
• Jaszianne Ashtrelle Tolbert, M.D.
• Aaron Tolen
• Addison Racoma Tolentino, M.D.
• Shawn J. Toliver
• Victoria Dale Tolo, RBT-REGISTERED BEHAV
• Mary Tolson, DPT
• Lauren Tomac
• Keri Ann Tombrello, AUD
• Abigail Tomczuk

• Adult Health Nurse Practitioner in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.